Facing the World (FTW) has been active internationally since 2002 and in Vietnam since 2008. The charity offers hope to children born with severe facial differences.
Facing the World (FTW) is run by volunteers who care passionately about the cause. This includes all doctors nationally and internationally, the CEO (Trustee) and all other professionals. Major corporations and foundations support our unique approach, and have donated generously in terms of cash, services and medical equipment.
The journey began with a focus on bringing children needing complex facial surgeries to the UK. One to two children were brought to the UK by FTW and treated by FTW UK partner hospitals annually with associated costs ranging from £50,000 to £1 million. Following an invitation by a US charity to visit Vietnam, FTW identified a real need, and in 2008 began running medical missions to Vietnam. A multidisciplinary team of FTW medics operated jointly with their Vietnamese counterparts on complex surgical cases.
A sustainable solution
Since then, FTW has developed a clear, sustainable strategy and solution which will lead to tens of thousands of children, initially in Vietnam and then beyond, receiving the treatment they need for often horrifically disfiguring birth defects. The charity has moved away from the model of treating one to two children a year at astronomical cost to a position where it is now able to operate on thousands of children with craniofacial defects and, crucially, is providing effective continuous training for local teams at partner hospitals. This model is based on a teaching platform replicable not only in Vietnam but in other countries in the longer term, and scalable in the medical field where talent has proven difficult to scale in the past.
Teach a man to fish
The key to this viable and sustainable solution is the teach a man to fish approach. FTW awards international training fellowships to Vietnamese medics and has already sent more than 80 to top medical institutions in the United Kingdom, Canada and the USA to observe and learn new techniques and approaches. A further 140 fellowships are currently in the planning. These fellowships are supplemented by in-country medical missions where complex surgeries are carried out by coordinated teams of the Vietnamese doctors and the international doctors involved in the fellowship program.
Partnering with a telemedicine platform is critical to a scalable and replicable approach. It enables the development of an outreach program in Vietnam, along with a two-way mentoring educational system with international partners.
The charity also works with its Vietnamese partners to identify other game-changing equipment needs, which are then met through donations.
The occurrence of birth defects in Vietnam is estimated to be 10 times higher than in neighboring countries, thought to be partly due to the legacy of Agent Orange.
In Vietnam, three medical systems run in parallel: the state system, reporting to the Ministry of Health; the military system, reporting to the Minister of Defense; and the private system, partly regulated by the Ministry of Health, but able to make non-medical decisions quickly.
FTW has a hub-and-spoke structure, where the private hospital, Hong Ngoc General, is the charity’s partner hub, with 108 Military Central Hospital’s Center for Craniofacial and Plastic Surgery (https://www.facebook.com/craniofacial108/) and Viet-Duc University Hospital and their networks being the spokes. 108 Military Central and Viet-Duc are among the top hospitals in Vietnam and via their networks of approximately 100 further hospitals and clinics, allow the charity’s reach to extend throughout the country, enabling treatment for the poor, primarily children, born with severe facial differences.
108 Center for Craniofacial and Plastic Surgery – the first of its kind in South East Asia.
In December 2018, HRH the Duke of York, opened the first Center for Craniofacial and Plastic Surgery in Vietnam on behalf of FTW. This was the result of nearly three years of strategic positioning among various members of the medical establishment, the government and Facing the World. Senior members of 108 Military Central Hospital had attended FTW fellowships in the UK and Canada. A blueprint was developed, with a clear and measurable 5 to 8 year plan including all ancillary specialists under a true multidiscipline approach.
So far 13 medics from the new Center have already taken part in the fellowship program in 2019 and two telemedicine platforms from InTouch Health have been approved and will shortly arrive at the hospital. These are the first steps in a new modular approach. It will offer a blueprint, with a clear start and end point that can be replicated elsewhere in the vast and ever-expanding international network. After 8 years, the Center will be able to reach and treat 60% of all children born in Vietnam with significant facial differences.
Our unique approach developed over the last ten years: Fellowships · In-country Training · Equipment Donation
Fellowships for Vietnamese medics are key to the charity’s success. The program started in the UK in 2015 and continues to expand its network which now includes the Hospital for Sick Children (SickKids) in Toronto, Canada, and The Children’s Hospital of Philadelphia, Johns Hopkins Hospital, and University of Maryland Shock Trauma Center in the USA. Since inception, over 80 Vietnamese medics have been offered fellowships to the UK, Canada and the USA, giving them the opportunity to observe and learn new techniques and approaches. As a result, the Difficult Airways Society (UK) has introduced its guidelines into Vietnam, and is collaborating intensively with the country. Over the next five years, FTW plans at least 200 more fellowships to top hospitals internationally. Fellowships are offered to doctors from hospitals where FTW is setting up craniofacial centers. Doctors are offered 2-6 week fellowships, all costs associated with which are covered by the charity (approx. £11,100 per 2 week fellowship, increasing incrementally). Craniofacial medicine and surgery consists of a multidisciplinary approach and as such all doctors, surgeons and ancillary specialists from each hospital are offered fellowships.
In-country Training builds on the fellowships, and is delivered by the charity’s teams during medical missions to Vietnam in which they and the Vietnamese teams operate jointly, putting the new approaches and techniques to use. The missions typically last a week and the international doctors who participate in the missions come exclusively from units where the fellowship program is active in the UK, Canada and the USA. This serves to build on the continual educational process. Since 2008, there have been on average two missions to Vietnam per year. Smaller additional missions covering specific surgical topics and approaches have proven a resounding success. FTW will now increase mission numbers over the next five years to between four and six per year. All missions now include teaching conferences to which doctors throughout Vietnam are invited.
Telemedicine: a crucial element for long term scalability. FTW has been able to donate to all of its partner hospitals in Vietnam telemedicine capability through the InTouch Health platform. This connectivity will allow foreign experts to continue advising and teaching on a regular basis without physically being in country. In the short term the charity expects to enable a link with one of its foreign partner centers, thereby once again extending the teaching possibilities. In the medium term this will be rolled out in a few strategic clinics across Vietnam, thereby facilitating an outreach program to bring expertise and screening to remote areas without the large capital expenditure which would otherwise be required.
Equipment needs are identified in collaboration with the charity’s partner hospitals in Vietnam. In the past two years alone, FTW has coordinated donations of £2 million of medical equipment, including InTouch telemedicine to Hong Ngoc, Viet-Duc, K (Cancer), and 108 Military Central hospitals as a start to extending the national and international linking and treatment capabilities.
Official status in Vietnam and other recent developments.
In Vietnam, FTW has been granted PACCOM registration. The charity has since signed MOUs with VAVA, the Vietnam Red Cross and Direct Relief. Direct Relief, one of the world’s largest foundations, has earmarked $100 million in potential donations annually to Vietnam, now that direct relationships with Vietnam have been facilitated by the charity.
Through intensive collaborations with Da Nang General Hospital, Viet-Duc University Hospital, 108 Military Central Hospital, and Hong Ngoc General Hospital and their respective inclusive networks, the charity can leverage its approach and expertise through the vast range of hospitals networked throughout Vietnam’s three medical systems. The charity has a Vietnamese patron and long-term financial supporters giving it a sound platform from which to continue to expand its services throughout Vietnam.
In 2017, the Rt Hon Theresa May, then British Prime Minister, commended the charity with a Points of Light award in recognition of excellence. The Vietnam Union of Friendship Organizations awarded the charity the medal for Peace and Friendship among Nations. The charity was also presented with the Vietnam President’s Medal for Friendship. It has been officially endorsed by the UK All-Party Parliamentary Group for Vietnam and the Vietnam-UK Network.
OUR SHORT TERM VISION: train 200 more doctors and perform